Исследование психологических особенностей детей и подростков с заболеваниями органов пищеварения

Objective: The present study was aimed at the psychological characteristics of children with different chronic diseases of the digestive system and the identification of key factors influencing the formation of their personality.Methods: The continuous prospective study of psychological peculiarities of 125 patients (7−17 y.o.) with diseases of the digestive system who have been monitored at Scientific Centre of Children’s Health (Moscow) was performed. As research methods were used: analysis of medical and pedagogical documentation, participant observation, educational experiment, interview, questionnaires and projective methods.Results: The study involved 125 patients aged 7–17 years (12.4 averagely) with diseases of the digestive system including teens — 68 (54%), primary school pupil — 57 (46%). The number of boys significantly prevailed over the number of girls (2:1). The study confirmed the existence of a close relationship and mutual influence of three factors: the physical condition, social situation of development, and individual psychological characteristics of children. According to the psychological characteristics the children can be combined in three groups: Group I (47 of 125 people; 37.6%) ― children with bad psychological status. This is most typical for children with active form of chronic diseases requiring intensive medical assistance (37 of 47 people; 78.7%). Group II (59 of 125 people; 47.2%) ― children with instable psychological condition, with risk of neurotization. This group mainly comprises patients with chronic diseases at the stage of unstable clinical remission with preserved or compensated functions of organism bodies and systems or with incomplete compensation of functions requiring long term supportive treatment (45 of 59 people; 76.3%). Group III ― patients with rather stable psychological condition (19 of 125 people; 15.2%). It comprises patients with rather stable psychological condition, anyway, with expressed psychological vulnerability in stress situation. Most children suffer from chronic diseases of different etiology at the stage of clinical remission with rare aggravations, with preserved or compensated functions, provided there are no aggravations of the basic disease (17 of 19 people; 89.5%).Conclusion: Most children with diseases of the digestive system have the psychological difficulties, while their identity is often formed in the distorted social conditions. Therefore, these children need psychological and pedagogical support, as well the special psychological and pedagogical conditions for the realization of their mental and cognitive capacities. To put together a program of psychological and educational assistance we should take into account the child’s age at the moment of occurrence of the disease, etiology, duration and severity of the illness, the nature and degree of non-compliance of social environmental.Цель исследования: изучить психологические особенности детей с различными хроническими заболеваниями органов пищеварения и установить основные факторы, влияющие на процесс формирования личности.Методы: проведено сплошное проспективное исследование психологических особенностей детей с болезнями органов пищеварения, наблюдавшихся в Научном центре здоровья детей Минздрава России (Москва). В качестве методов исследования были использованы анализ медицинской и педагогической документации, включенное наблюдение, беседа, опросный и проективный методы.Результаты: обследовано 125 пациентов в возрасте 7−17 (средний возраст 12,4) лет с болезнями органов пищеварения, из них подростков — 68 (54%), младших школьников — 57 (46%). Число мальчиков преобладало над числом девочек (2:1). В исследовании подтверждено наличие связи и взаимного влияния 3 факторов — физического состояния, социальной ситуации развития и индивидуальных психологических характеристик детей. По психологическим особенностям детей можно было объединить в 3 группы: I (n =47; 37,6%) ― дети в тяжелом психологическом состоянии, у большинства из которых (n =37; 78,7%) заболевание находилось в активной стадии, требующей интенсивной медицинской помощи; II (n =59; 47,2%) ― дети с неустойчивым психологическим состоянием и высоким риском невротизации личности, у многих из которых (n =45; 76,3%) заболевание находилось в стадии нестойкой клинической ремиссии с сохраненными или компенсированными функциями органов и систем организма либо неполной компенсацией функций, требующей длительного поддерживающего лечения; III (n =19; 15,2%) ― пациенты с относительно стабильным психологическим состоянием и высокой психологической уязвимостью в ситуации стресса, у большинства из которых (n =17; 89,5%) болезнь перешла в стадию клинической ремиссии c редкими обострениями, с сохранными или компенсированными функциями, требующую регулярного контроля врачами-специалистами.Заключение: большинство детей с болезнями органов пищеварения имеют психологические трудности, и их личность формируется в искаженных социальных условиях, ввиду чего они нуждаются в психолого-педагогической поддержке и создании специальных психолого-педагогических условий для реализации их психологического и познавательного потенциала. При составлении программы психолого-педагогической помощи необходимо учитывать возраст ребенка на момент возникновения болезни, этиологию и степень тяжести заболевания ребенка, длительность, характер и выраженность несоответствия социальных условий среды его возрастным и индивидуальным психологическим потребностям

Guidelines for Psychological Assistance to Chronically Ill Children and Their Parents

This study explored psychological features in 33 children aged 8—17 years suffering from rheumatic disorder and in their mothers. 11 children were in the emergency department, 22 in the department of rheumatology. The following methods were used: observation, conversation, the Draw-a-Person and Three Wishes tests, the Dembo-Rubinstein self-esteem scales, and the Parent’s Essay technique. According to the level of their mental activity the children were divided into 4 groups: ‘inactive’, ‘passive’, ‘relatively active’ and ‘active’. Working with the ‘inactive’ children was impossible; the main task was to help their mothers cope with emotional distress. The ‘passive’ children received emotional support and were taught how to understand and express their needs; their parents were taught how to communicate with the child in various ways. Working with the ‘relatively active’ children and their parents had the aim of reestablish- ing productive interactions between them. Working with the ‘active’ children consisted of supporting their self-esteem, self-respect and interests; their parents were taught to better understand age-specific and indi- vidual psychological features of the child and to take into account limitations caused by the illness

PSYCHOLOGICAL CARE FOR SCHOOL-AGE PATIENTS WITH CORONAVIRUS INFECTION IN THE HOSPITAL

For the first time in pediatric practice, the psychological state of 100 children (7-17 years old) with COVID-19 in the state of hospitalization was studied on the basis of the Scientific Medical Research Center of Children's Health of the Russian Ministry of Health Care and the directions of psychological and pedagogical assistance were determined. Analysis of medical and psychological-pedagogical documentation, conversation, observation, screening diagnostics were conducted. It was established that according to the totality of physical and psychological factors (the main psychological difficulty) patients can be grouped into the following groups: children in a severe physical state, with unstable manifestations of mental activity (n = 4; 4%); children in a predominantly moderately severe state with significant distress related to the disease (n = 48; 48%); children in a satisfactory physical state, with mild and mostly situational difficulties in adapting to the situation of hospitalization (n = 46; 46%); children in a satisfactory physical state, in a relatively stable positive psychological state (n = 2; 2%). Consideration of the severity of their physical and psychological condition and their basic psychological difficulties allows differentiated psychological aid to be rendered to children and teenagers in special conditions of the «red zone»